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Evaluation of intra-abdominal solid organ injuries in children
1. bsrnayse@gmail.com.
Insights
Pediatric abdominal solid organ injuries are often blunt traumas. Computed tomography angiography (CTA) aids diagnosis and treatment planning, with over 90% of pediatric solid organ injuries successfully managed non-surgically.
Area of Science:
- Pediatric Traumatology
- Abdominal Imaging
- Emergency Medicine
Background:
- Intra-abdominal solid organ injuries are a significant concern in pediatric trauma.
- Accurate diagnosis and grading are crucial for appropriate management.
- Imaging modalities play a vital role in evaluating these injuries.
Purpose of the Study:
- To investigate the characteristics and severity of intra-abdominal solid organ injuries in pediatric patients.
- To evaluate the role of imaging, specifically ultrasound (US) and computed tomography (CT), in diagnosing these injuries.
- To correlate imaging findings with injury patterns and treatment outcomes.
Main Methods:
- Retrospective analysis of 1066 pediatric patients with suspected abdominal injuries.
- Evaluation of patient demographics, injury mechanisms, and physical examination findings.
- Assessment of abdominal US and CT scan results, including injury type, localization, and grade.
Main Results:
- Blunt trauma accounted for 92.8% of injuries, with motor vehicle accidents being the most common mechanism (41.4%).
- Liver (47%), spleen (36%), and renal (17%) injuries were most frequently observed.
- Grade II injuries were the most common, and 96.5% of patients were managed conservatively.
Conclusions:
- Pediatric abdominal solid organ injuries are predominantly blunt in nature and can be severe.
- CT angiography is essential for accurate injury assessment and treatment guidance.
- Conservative management is highly successful in the majority of pediatric solid organ injuries.
Aim:
In our study we investigated characteristics and degree of intra-abdominal solid organ injuries according to tomographic imaging in pediatric patients who presented to our emergency clinic with possible abdominal injuries and to whom US and/or abdominal tomography were applied.
Materials And Methods:
1066 pediatric patients were included in the study. The age, gender, injury localization, injury type, injury mechanism, abdominal US and CT results, and treatment specifics of patients were evaulated.
Results:
58.5% of cases were male. Average age of children was 7.1±4.6 70.8% of the injuries occured in the outdoors. As for injury type, 92.8% of the injuries were blunt and 7.2% were penetrating traumas. The most common mechanism of injury was motor vehicle accidents at 41.4%. The most common abdominal physical examination finding was tenderness with a prevelance of 67%. In patients with solid organ injury, liver injury was detected in 47% of patients, spleen injury was detected in 36% of patients and renal injury was detected in 17% of patients. Grade II injury was the most common grade. 96.5 of patients were provided conservative treatment and 3.5% of patients were treated surgically.
Conclusion:
Solid organ injuries due to abdominal trauma in children are generally related to blunt trauma and are severe injuries. CT angio is an important imaging method for detecting solid organ injuries, classification of the injury and treatment determination. Greater than 90% of solid organ injuries in children can be treated successfully with conservative methods.
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